Developing the Risk Nomogram Model of Low Triiodothyronine Syndrome in Elderly Patients with Chronic Heart Failure
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2024.0907.002
- VernacularTitle:老年慢性心力衰竭患者发生低三碘甲状腺原氨酸综合征风险列线图模型的建立
- Author:
Xiaoli FENG
1
;
Zhenhua LI
1
;
Huimin CHEN
1
;
Wenzhi XIE
1
;
Liliang CHEN
1
Author Information
1. Department of Geriatric Medicine， Anqing Municipal Hospital， Anqing 246000， China
- Publication Type:Journal Article
- Keywords:
chronic heart failure;
low triiodothyronine syndrome;
serum albumin;
risk factors;
nomogram
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2024;45(5):844-852
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThe clinical characteristics and the possible risk factors were explored for the low triiodothyronine syndrome （LTS） in elderly patients with chronic heart failure （CHF）， and the risk prediction model of LTS was established. MethodsFor this research， 291 elderly patients with CHF were selected as sample and retrospectively reviewed was used as analytical method. According to the thyroid function of admission patients， two groups including LTS group （n=107） and normal thyroid function group （n=184） were divided. The general information and biochemical indicators of patients were collected and recorded， and the risk factors for LTS were assigned scores， in which numerical variables （except age） were grouped by median. The chi-squared test was used for statistical analysis of each variable， and multivariate regression model was used to analyze the independent risk factors of LTS in elderly patients with CHF， then the nomogram model for LTS was established based on the results from the final regression analysis. Furthermore， the prediction model was evaluated using C-index， calibration curve and receiver operating characteristic （ROC） curve. ResultSerum creatinine （Scr）， C-reactive protein （CRP）， interleukin-6 （IL-6） and the cardiac functional grading according to the New York Heart Association （NYHA） were positively correlated with LTS （OR values were 1.893， 2.356， 1.021 and 1.815， respectively， P < 0.05）， serum Albumin （Alb） was negatively correlated with LTS （OR = 0.412， P < 0.05）. This means that， the LTS was easily occurred as the serum Alb level declined. When introduce the above statistically significant variables into nomogram obtained the C index with 0.807 ［95% CI = （0.757， 0.856）］. The calibration curve verified by internal verification showed that the calibration degree of this prediction model was well calibrated. ROC curve analysis showed that the prediction model was well differentiated. ConclusionThe Scr， CRP， IL-6， Alb and cardiac functional grading in elderly CHF patients may be risk factors for incidence of LTS， while serum Alb may be a protective factor for LTS. Based on the above risk factors， the nomogram model for predicting the occurrence of LTS in elderly CHF patients had good differentiation and accuracy， and can provide guidance for clinical individualized prevention and treatment.
